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NPI Code Detail

MEDICARE: NICHOLE CAMPBELL OTRL

MEDICARE: NICHOLE CAMPBELL OTRL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist13702MA

General Provider Information

NPI Number : 1639843337
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICHOLE CAMPBELL OTRL
Provider Business Mailing Address
First Line : 67A SEA AVE
Second Line :
City : QUINCY
State : MA
Zip : 02169-3127
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 60 SHARP ST
Second Line :
City : HINGHAM
State : MA
Zip : 02043-4334
Country : US
Telephone Number : 781-335-6663
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/05/2021
Last Update Date : 08/05/2021

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Directions to “ NICHOLE CAMPBELL OTRL” Practice Location

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